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|Title: ||Renal protective efect of sacubitril/valsartan in patients with heart failure|
|Authors: ||Hsieh, Hui Ling;Chen, Chun You;Chen, Cheng Hsien;Hsu, Shih Chang;Huang, Wen Cheng;Sue, Yuh Mou;Lin, Feng Yen;Shih, Chun Ming;Chang, Yue Cune;Huang, Po Hsun;Liu, Chung Te|
|Issue Date: ||2021-03-04 12:12:05 (UTC+8)|
|Abstract: ||Sacubitril/valsartan is a combined neprilysin inhibitor/angiotensin II receptor blocker designed for|
treatment of heart failure (HF). Nonetheless, its renal protective effect remained an issue of debate.
This retrospective cohort study investigated the renal protective effect of sacubitril/valsartan in HF
patients. HF patients on sacubitril/valsartan or valsartan for > 30 days were matched for gender, age,
estimated glomerular filtration rate (eGFR), and left ventricular ejection fraction (LVEF) to be enrolled
into analysis. The follow-up period was 18 months. The outcomes included end eGFR, renal function
decline defined as 20% reduction of eGFR, mortality, and HF-related hospitalization. Each group had
137 patients after matching. The mean age was 72.7 years and 65.7% were male. Mean eGFR was
70.9 mL/min/1.73 m2 and LVEF was 54.0% at baseline. Overall, the eGFR of sacubitril/valsartan groups
was significantly higher than valsartan group at the end (P < 0.01). Subgroup analysis showed that
the difference in eGFR was significant in subgroups with LVEF ≥ 40% or eGFR ≥ 60 mL/min/1.73 m2.
Multivariate Cox regression model showed that sacubitril/valsartan group had significantly reduced
risk for renal function decline (hazard ratio: 0.5, 95% confidence interval: 0.3–0.9). Kaplan–Meier
curve showed no difference in the risk for cardiovascular mortality, all-cause mortality or HF-related
hospitalization. We showed renal protective effect of neprilysin inhibition in HF patients and specified
that subgroups with LVEF ≥ 40% or eGFR ≥ 60 mL/min/1.73 m2 were sensitive to this effect, suggesting
an optimal subgroup of this treatment.
|Relation: ||Scientific Reports 11(1), 4593|
|Appears in Collections:||[Graduate Institute & Department of Mathematics] Journal Article|
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